1. Start with Open Ended questions.

For example, “What brings you into the clinic today?” or “How is your sleep?”

Letting the patient talk and describe their experience in their own words is key. Open ended questions allow for an open dialogue and avoids biased and non-descriptive answers. A Closed Ended or Leading question limits the patient and is often used after open ended questions to further clarify specific details of the concern. Closed Ended questions can often be answered with one-word answers or with ‘yes/no’ responses.

For example, “Is your pain stabbing?” or “Do you wake up in the middle of the night?”

2. LO DR FICARA

LO DR FICARA is an acronym that helps to guide the practitioner in identifying all the important descriptions of each concern:

L- Location: Where is the symptom felt?

O- Onset: When did it start? Is there a correlating event? Is there a pattern to the onset (ie. time of day, after you eat, trauma)? Has this happened before?

D- Duration: How long does the symptoms last for (ie. minutes, weeks, years)?

R- Radiation/Referral: Does the physical sensations radiate or refer anywhere else in the body? What does it feel like?

F- Frequency: How often do you experience the symptom?

I- Intensity: Rating the sensation on a scale of 1-10, where 10 is the most extreme of the symptom. This is especially important because sensations are subjective and provides a numerical value to compare to in the future.

Following this protocol can help identify what issue is going on with our patients. Once a clear picture is generated, the next question is to ask if there are any “RED FLAGS” that indicate for critical or emergent actions.

For example, this patient most likely has a left sided herniated disc that is causing an impingement on the left sciatic nerve from an acute trauma while lifting a heavy object with improper form.

NOW WHAT?

Following up with specific Close Ended questions and physical exams will help to Rule Out emergent cases. Never let your patients leave your office until you have clearly eliminated critical conditions and have made appropriate referrals.

This website is NOT to be used as a diagnostic or treatment tool. Always consult with your Conventional Medical Doctor or Naturopathic Doctor for specific concerns. In cases of medical emergencies visit your nearest hospital or call 9-1-1.